1546例乙型肝炎患者血清HBV-M、HBVDNA、肝功能检测结果分析

Analysis of Serum HBV Markers,HBV DNA and Liver Function Indicators in 1546 Cases of Patients with Hepatitis B

目的探讨乙型肝炎患者血清病毒复制指标(HBVDNA)与乙肝标志物及肝功能关系。方法对1546例乙肝患者分别用荧光定量聚合酶链反应(FQ-PCR法)检测血清样本中HBVDNA载量,酶联免疫吸附法测定血清中HBV-M,并同步检测肝功能。首先按HBV-M结果分组探讨与HBVDNA载量关系,再按HBVDNA载量高低分组探讨病毒载量与肝功能关系。结果大三阳组HBVDNA载量及阳性率显著高于其他各组(P<0.01),ALT水平随HBVDNA病毒载量升高而升高,AST水平在无病毒载量与有病毒载量组间存在显著性差异,并不随病毒载量的升高而升高,CHE水平与病毒载量高低无关。结论 HBeAg与HBVDNA载量关系密切,HBeAg阴转不表示病毒停止复制,HBVDNA可反映HBV在外周血的复制情况,并不能反映肝脏损伤程度及预后。

Objective To study the association among HBVDNA level（viral load）,HBV Markers and liver function indicators in chronic hepatitis B patients.Methods A total of 1546 hepatitis B patients were recruited in this study.Peripheral HBV viral loads were quantified by fluorescence quantitative polymerase chain reaction（FQ-PCR）.Also,serum HBV-M level and liver function indicators（ALT/AST/CHE） were detected by enzyme linked immunosorbent assay（ELISA） and traditional biochemical method separately.The association between HBV-M and HBVDNA level was primarily investigated according to group strategy with HBV-M level and then the association between HBV viral load and ALT/AST was studied according to group strategy with HBVDNA level.Results HBV viral load level and positivity were significantly higher in HbeAg-positive patients than those in other groups（P0.01）.ALT levels enhanced with the increase of HBVDNA level.There was significant difference in the AST level between patients with or without HBV viremia while no positive association was found between AST level and HBV viral load.Additionally,CHE level had nothing to do with the level of HBV viral load.Conclusion HBeAg level was positively correlated with HBV viral load and negative conversion of HBeAg had no implication for HBV silencing viral replication.HBVDNA level reflected HBV replication in the peripheral blood to a large degree,while it did not reflect the degree of liver injury and prognosis.